What are the treatment options for allergic rhinitis (seasonal allergies)?

From the Guidelines

For initial treatment of seasonal allergic rhinitis in persons aged 12 years or older, intranasal corticosteroid monotherapy is the recommended approach. This is based on the strong recommendation from the 2017 joint task force on practice parameters, as outlined in the Annals of Internal Medicine 1. The guideline suggests that intranasal corticosteroids should be prescribed over combination therapy with an oral antihistamine for initial treatment.

Key Treatment Options

• Intranasal corticosteroids: These are the preferred initial treatment for seasonal allergic rhinitis in persons aged 12 years or older, due to their effectiveness in reducing inflammation and symptoms 1.
• Oral antihistamines: While not recommended as initial monotherapy, oral antihistamines can be considered for additional symptom relief, especially for patients with mild symptoms.
• Leukotriene receptor antagonists: These may be considered as an alternative to intranasal corticosteroids, but are not recommended as first-line treatment for persons aged 15 years or older 1.

Additional Considerations

• For patients with moderate to severe seasonal allergic rhinitis, combination therapy with an intranasal corticosteroid and an intranasal antihistamine may be considered for initial treatment, although this is a weak recommendation 1.
• Allergen avoidance and environmental management are also crucial in managing seasonal allergic rhinitis, including keeping windows closed during high pollen seasons and using air purifiers with HEPA filters.
• If symptoms persist despite initial treatment, consultation with a healthcare provider about prescription options or allergy immunotherapy may be necessary.

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP relieves allergy symptoms caused by pollen, mold, dust and pets. Fluticasone Propionate Nasal Spray, USP helps relieve a broad range of symptoms from many allergens. For example, Fluticasone Propionate Nasal Spray, USP helps with: Can I use Fluticasone Propionate Nasal Spray, USP for colds? No, use Fluticasone Propionate Nasal Spray, USP to treat only your allergies – not your cold symptoms What are the differences in the way children age 4 to 11 should use Fluticasone Propionate Nasal Spray, USP? Children age 4 to 11 should use a lower dose of Fluticasone Propionate Nasal Spray, USP for a shorter period of time 24 Hour Relief of: •Sneezing •Runny Nose •Itchy, Watery Eyes •Itchy Throat or Nose

The treatment options for allergic rhinitis (seasonal allergies) include:

• Nasal Sprays: Fluticasone Propionate Nasal Spray, USP is an effective allergy medicine that relieves symptoms caused by pollen, mold, dust, and pets.
• Oral Antihistamines: Cetirizine Hydrochloride Tablets USP provide 24-hour relief of symptoms such as sneezing, runny nose, itchy, watery eyes, and itchy throat or nose 2 3. Key considerations:
• Always follow the instructions for use and dosage recommendations for each medication.
• Children aged 4-11 should use a lower dose of Fluticasone Propionate Nasal Spray, USP for a shorter period of time.
• If symptoms persist or worsen, consult a healthcare professional for further guidance.

From the Research

Treatment Options for Allergic Rhinitis

The treatment options for allergic rhinitis (seasonal allergies) include:

• Intranasal corticosteroids, such as fluticasone propionate aqueous nasal spray 4, 5, 6
• Oral antihistamines, such as loratadine, cetirizine, and chlorpheniramine 4, 7, 5, 8
• Combination therapy of intranasal corticosteroids and oral antihistamines 4, 5

Efficacy of Treatment Options

• Fluticasone propionate aqueous nasal spray has been shown to be effective in reducing nasal symptom scores and improving quality of life in patients with seasonal allergic rhinitis 4, 6
• Cetirizine has been shown to be effective in reducing total symptom severity complex (TSSC) scores in children with seasonal allergic rhinitis 8
• Combination therapy of fluticasone propionate and cetirizine has been shown to be effective in reducing nasal symptom scores and improving quality of life in patients with seasonal allergic rhinitis 5
• Loratadine has been shown to be less effective than fluticasone propionate in reducing nasal symptom scores, but may be effective in combination with other medications 4, 7

Safety and Tolerability

• Fluticasone propionate aqueous nasal spray has been shown to be safe and well-tolerated, with no significant adverse events reported 4, 6
• Cetirizine has been shown to be safe and well-tolerated, with somnolence reported in a small number of patients 8
• Loratadine has been shown to be safe and well-tolerated, with no significant adverse events reported 4, 7